Need For Services Research Articles

Unlocking mental well-being: The role of workplace social support and organisational justice in the public service

Research purpose: This study sought to determine the relationship between public service employee’s mental health accounting for the role of organisational justice and workplace social support.Motivation for the study: Calls exist to understand issues of mental health within the confines of the organisation.Research approach/design and method: A survey approach utilising a convenience sample of 289 public service employees as respondents was utilised. The location of the study was the Eastern Cape province, South Africa.Main findings: The findings show that workplace social support has a direct and positive relationship with employee mental health. Organisational justice has no significant relationship with employee mental health. Workplace social support was found to fully mediate the relationship between organisational justice and employee mental health.Practical/managerial implications: Strategies can be put in place that inform the promotion of mental health with the public service. These include the need for support services to promote mental health to address organisational issues that impede the pathway of such interventions.Contribution/value-add: The findings proffer useful precursors to interventions that address the challenge of mental health.

Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results.

In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus. The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians. Quantitative and qualitative methods were used to analyze the data. A total of 669 providers responded to this combined survey. Results indicated that compared to DOD and VHA providers in other fields, audiologists tended to be more confident and more aware of their role in tinnitus management. In terms of confidence and scope of practice, DOD mental health care providers were the group least familiar with tinnitus care. Other results explored herein include barriers to tinnitus care, facilitators for progressive tinnitus management programs, interventions and patient materials offered, new patient materials wanted, and respondents' preferred information sources and training methods. Survey results indicated that more directed education and support are needed to increase DOD and VHA clinicians' awareness of the need for tinnitus services and their roles in providing that care. https://doi.org/10.23641/asha.27229215.

"I don't feel fully prepared": a qualitative study of recently graduated students' mental health experiences of the transition out of university.

This study aimed to better understand the mental health experiences of students as they prepared to transition out of university. Participants included 18 recently graduated students from a Canadian university. Virtual one-on-one semi-structured qualitative interviews were conducted and analyzed following the protocol for content analysis and using QSR NVivo. Four main themes were identified, including: distress and feelings of doubt, the importance of connections, the impact of the COVID-19 pandemic, and experiences with mental health service use. Participants discussed feeling pressured to succeed and a fear of failure, uncertainty and unpreparedness for next steps, the importance of connections to peers and professors, a lack of motivation and feeling 'unfinished' due to the COVID-19 pandemic response, and the need for flexible and accessible mental health services to address immediate and longer-term needs. Results have implications for better support of students as they prepare for graduation.

High-cost users still came to hospitals during the COVID-19 pandemic during first wave data in Thailand: secondary data analysis

BackgroundThe phenomenon of high-cost users (HCUs) in health care occurs when a small proportion of patients account for a large proportion of health care expenditures. By understanding this phenomenon during the COVID-19 pandemic, tailored interventions can be provided to ensure that patients receive the care they need and reduce the burden on the health system.ObjectivesThis study aimed to determine (1) whether the HCUs phenomenon occurred during the pandemic in Thailand by exploring the pattern of inpatient health expenditures over time from 2016 to 2021; (2) the patient characteristics of HCUs; (3) the top 5 primary diagnoses of HCUs; and (4) the potential predictors associated with being an HCU.MethodsThe secondary data analysis was conducted via inpatient department (IPD) e-Claim data from the National Health Security Office for the Universal Coverage Scheme, which provides health care to ~ 80% of the Thai population. Health care expenditure over time was calculated, and the characteristics of the population were examined via descriptive analysis. Multinomial logistic regression was applied to explore the potential predictors associated with being an HCU.ResultsThe characteristics of HCUs remained relatively the same from 2016 to 2021. In terms of the proportion of male (55%) to female patients (45%), the age ranged from 55 to 57 years, with an estimated 8-day length of hospital stay and 7 admissions per year, and the average health care cost per patient was ≥ USD 2,860 (100,000 THB). The low-cost users (LCUs) group (the bottom 50% of the population), had more female patients (55%), a younger age ranging from 27 to 33 years, a 3-day length of stay, 1‒2 admissions per year, and a lower average health care cost per patient, which was less than USD 315 (≤ 11,000 THB).ConclusionThe HCUs phenomenon still existed even with limited health care accessibility or lockdown measures implemented during the COVID-19 pandemic. This finding could indicate the uniqueness of the need for health services by HCUs, which differ from those of other population groups. By understanding the trends of health care utilization and expenditure, along with potential predictors associated with being an HCU, policies can be introduced to ensure the appropriate allocation of health resources to the right people in need of the right care during future pandemics.

"I Needed to be That Voice": A Multi-Party Study of the Healthcare and Social Service Experiences and Needs of Transgender and Gender-diverse Older Adults in Canada.

The social contexts of transgender and gender-diverse (TGD) older adults remain under-examined. In this qualitative study, which involved six virtual focus groups with a total of 21 participants inclusive of TGD adults ages 50+, service providers, and community advocates, we sought to examine the healthcare and social service experiences and needs of TGD older adults in Canada. Drawing theoretically on critical gerontology and intersectionality, and methodologically on interpretive description, we examined the perspectives of different participant groups to develop insight into TGD older adults' issues and priorities in the context of their engagements with systems of care. Our findings revealed the role of histories of marginalization, precarity, contemporary sources of intersectional oppression, and resistance in shaping the experiences of this population, while also highlighting community-driven ground-up activities to address evolving needs. Drawing on this conceptualization, we explored the implications of our research for ongoing inquiry, policy, and practice.

When library cares: mining insights from LibQUAL+ to determine university students’ priorities

PurposeThis study aims to evaluate students' satisfaction with university library services in southern Punjab, Pakistan, emphasizing their perspective on service quality (SQ).Design/methodology/approachA LibQUAL+® survey with 22 core items was conducted within university settings using convenience sampling. In total, 345 usable responses were returned through Google Forms. Data analysis involved descriptive statistics, ordinal logistic regression test, Pearson and Deviance statistics and chi-square test to assess the satisfaction status of library users.FindingsThe study found that libraries generally meet SQ standards. However, there were minor gaps in information control (IC) and library as place (LP).Practical implicationsThe study provides library administrators with actionable insights to enhance services, encouraging stakeholders to adopt optimal library practices for heightened efficiency and user satisfaction.Social implicationsIt highlights the crucial role of libraries in shaping future societal progress by emphasizing the need for elevated user services. Librarians can use this knowledge to modify their planning and take impactful initiatives that align with the evolving needs of their users.Originality/valueWhile many studies have utilized LibQUAL, this research is unique for its focus on addressing university library services in underdeveloped regions facing economic challenges. It attempts to fill the information gap by offering a transferable approach for strategic priorities in similar settings.

Primary healthcare rehabilitation users' views on activity limitations and participation in South Africa.

Increasing functional limitations and disabilities have raised the need for comprehensive rehabilitation services at the primary healthcare (PHC) level, particularly in low- and middle-income countries. To support the integration of these services into PHC in South Africa, assessing outcomes from the service users' perspectives is essential. This study examined service users' views on their PHC rehabilitation outcomes in a Metropolitan District of Gauteng, South Africa. The aim was to understand perceived changes in activity limitations and participation restrictions following the rehabilitation intervention. A quantitative survey design, including self-rating measurements and structured interviews, was employed. Thirty-eight rehabilitation service users from eight clinics and community health centres were purposively sampled. Participants rated their pre- and post-rehabilitation levels of difficulty in activity limitations and participation restrictions, with open-ended questions providing additional insights. Data analysis used descriptive statistics, quantitative content analysis, and non-parametric tests. Significant improvements in mobility, self-perception, and quality of life were reported by both adult and child service users. Caregivers of child service users also noted positive experiences (p = 0.019) in community, social, and civic life. This study highlights the perceived positive changes experienced by PHC rehabilitation service users in addressing functional limitations and disabilities. It underscores the effectiveness of integrated rehabilitation service delivery in improving user outcomes. The findings offer valuable insights into how rehabilitation interventions enhance functional abilities, social participation, and overall well-being. By focusing on activity limitations and participation restrictions from service users' perspectives, this study supports the priority of providing person-centred rehabilitation services at the PHC level.

Legal Consequences of Authentic Deed with False Identity Against Notary

Given the very important role of Notaries in upholding justice and truth in society, everyone who participates in law enforcement is obliged to carry out their duties with integrity and devotion, thus raising the degree of the Notary profession to a noble level (officium nobile). This can lead to increasingly complex and challenging tasks amidst the increasingly intense competition between Notaries, which in turn causes some Notaries to be less careful in carrying out their official obligations. The rapid changes in society are accompanied by the increasing need for Notary services, especially in the midst of globalization. People need Notary services in order to carry out their legal obligations, especially in the framework of civil law, where the implementation of a legal action depends on the existence of supporting documents such as letters or documents. This deed is often made by a Notary in the form of an original deed, so that it has more legal weight because of its official and legal existence. Notaries are public officials who have the authority to make Deeds and other legal authorities, as stated in Law Number 2 of 2014 concerning Amendments to Law Number 30 of 2004 concerning Notary Offices. In Indonesia, the legal system is very important to resolve various disputes between the government and the community. Another indication that legal certainty has been guaranteed is the stipulation or legalization of a contract by a Notary. The purpose of this normative legal research is to examine laws and regulations relating to the position and duties of Notaries in society

Exploration of preschool hearing screening at primary healthcare centers in Riyadh, Saudi Arabia: A cross-sectional study

The hearing status of children should be examined throughout early childhood, even if they have passed the newborn hearing loss because hearing loss can occur at any time and may affect their ability to learn. Preschool hearing screening (PHS) is vital to continue screening throughout early childhood. The current practice of PHS in the primary healthcare centers (PHCs) in Saudi Arabia is unknown. The purpose of this study was to investigate PHS in the PHCs. This cross-sectional descriptive study used an in-person-administered questionnaire to collect data. A total of 106 out of 120 participants (male = 61; female = 45) representing the PHCs in Riyadh were interviewed. Most of the participants were aged 31–40 years and held a bachelor's degree as the highest academic qualification with limited years of experience. PHS was mostly performed through subjective measures by asking the parents (71.7%) and the child (65.1%). The audiometric evaluation was conducted for preschool children in only half of the PHCs. General practitioners and nurses usually perform PHS. Substantial gaps in the practice of PHS were identified. The lack of training and appropriate instruments and the need for audiological services were the main challenges. Incorporating robust and objective protocols for PHS into the educational system is a valuable strategy for identifying hearing loss early and reducing its impact through the establishment of effective intervention plans.

Prevalence of sexually transmitted infections and associated risk factors among female sex workers in Guinea-Bissau

ObjectiveTo estimate the prevalence of the curable sexually transmitted infections (STIs) Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and Treponema pallidum, to identify associated risk factors and to assess...

Implementation of Standard Physiotherapy Service Policies In Puskesmas: Literature Review

The growing prevalence of non-communicable diseases (NCDs) such as hypertension, stroke, diabetes, joint disorders, lack of physical activity, injury, and disability has resulted in an increasing need for physiotherapy services within healthcare facilities, especially at community health centers. Despite many unresolved public health issues, the rise of NCDs continues to pose significant challenges. According to the Minister of Health Regulation No. 65 of 2015, physiotherapy services are crucial in primary healthcare as part of promotive and preventive efforts, without neglecting curative and rehabilitative functions. This study aims to highlight the importance of physiotherapy in community health centers in providing both preventive and supportive care to address the public's increasing healthcare demands. The findings emphasize the strategic role of physiotherapists in disease prevention and health promotion at the primary level. The novelty of this research lies in its focus on the integration of physiotherapy into primary care services as a proactive approach to managing NCDs. The contribution of this research is to support healthcare policy and practices that prioritize physiotherapy services to improve public health outcomes, particularly in the prevention and management of NCDs.

Drivers of Food Service Need and Use among Non-Hispanic Black and Hispanic Men with Chronic Conditions in the United States

Drivers of Food Service Need and Use among Non-Hispanic Black and Hispanic Men with Chronic Conditions in the United States

Consensus palliative care referral criteria for people with chronic obstructive pulmonary disease

ObjectivePeople with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral.We conducted a Delphi study of...

Bidirectional association between frailty and quality of life within English longitudinal study of aging.

The relationship between quality of life (QoL) and frailty has previously been investigated cross-sectionally and longitudinally as unidirectional where QoL depends upon frailty and where frailty depends on QoL. Here a bidirectional relationship is examined. This work uses a latent curve model with structured residuals to address the bidirectional association between QoL and frailty in older English people considering within-person and group levels. The study measures frailty using a functional frailty measure and quality of life using CASP-12. The sample size is 17,529. There is a strong relationship between QoL (Quality of Life) and frailty, which is almost linear and inversely proportional over time. Although the cross-lagged coefficients from QoL to frailty and vice versa showed statistical significance, the impact was found to be minimal. The time between assessments (which are two years apart) and/or the few observations available per individual may have impacted the effect of this relationship. When accounting for gender, age, net wealth, and multimorbidity, some variations in the results were observed at the group level but not at the within-person level. The study provides empirical evidence that supports a bidirectional association between QoL and frailty in older individuals who reside at home. These results offer valuable insights for healthcare providers, as participants did not exhibit an advanced need for health services. Additionally, involving participants in evaluating and assessing these services enhances their effectiveness and overall benefit.

Adapting Group Model Building for Mental Healthcare: A Participatory Co-Design Approach.

Countries around the world are experiencing both a growing need for mental health services and major gaps in the delivery of mental healthcare. The World Health Organisation's 2022 report on mental health emphasised co-designed and systems-level innovations responsive to the voice of those with lived experience. However, evidence for implementing such methodologies is sparse. Group model building (GMB), a participatory systems-based approach, has been used in various fields, but its application is limited within mental healthcare settings. It is recognised as a valuable tool for engaging stakeholders, including those with lived experience, in understanding and redesigning health systems and services. The participatory approach aligns with the mental health sector's shift towards co-design and person-centred care. This study assessed the acceptability of GMB as a method for co-design within mental healthcare, aiming to explore its potential for meaningful collaborative improvement and systems-level insights. Participants from a regional Mental Health and Drug and Alcohol Service (MHDAS) engaged in GMB workshops and focus groups. Eighteen individuals, including lived experience workers and healthcare professionals, provided feedback that informed adjustments to the workshops' design, language, timing and facilitation techniques, enhancing GMB's relevance for mental health co-design. The findings demonstrate the value and acceptability of the adapted GMB process in acute mental healthcare, marking a significant step towards evidence-based, person-centred service improvement. This study highlights the potential effectiveness of participatory methods in identifying and addressing systemic challenges, paving the way for future mental health reforms. Future work will focus on implementing and evaluating co-designed interventions, aiming for more inclusive and effective mental healthcare and advancing innovation and reform in the field.

Outcomes After Loss to Follow-Up for Pregnant and Postpartum Women Living With HIV and Their Children in Kenya: A Prospective Cohort Study.

Many prevention of vertical transmission (PVT) studies assess outcomes within 12 months postpartum and exclude those lost to follow-up (LTFU), potentially biasing outcomes toward those retained in care. Five public facilities in western Kenya. We recruited women living with HIV (WLH) ≥18 years enrolled in antenatal clinic (ANC). WLH retained in care (RW) were recruited during pregnancy and followed with their children through 6 months postpartum; WLH LTFU (LW, last visit >90 days) after ANC enrollment and ≤6 months postpartum were recruited through community tracing. Recontact at 3 years was attempted for all participants. Primary outcomes were retention and child HIV-free survival. Generalized linear regression was used to estimated risk ratios (RRs) for associations with becoming LTFU by 6 months postpartum, adjusting for age, education, facility, travel time to facility, gravidity, income, and new vs. known HIV positive at ANC enrollment. Three hundred thirty-three WLH (222 RW, 111 LW) were recruited from 2018 to 2019. More LW versus RW were newly diagnosed with HIV at ANC enrollment (49.6% vs. 23.9%) and not virally suppressed at study enrollment (40.9% vs. 7.7%). 6-month HIV-free survival was lower for children of LW (87.9%) versus RW (98.7%). At 3 years, 230 WLH were retained in care (including 51 previously LTFU before 6 months), 30 transferred, 70 LTFU, and 3 deceased. 3-year child HIV-free survival was 81.9% (92.0% for children of RW, 58.6% for LW), 3.7% were living with HIV, 3.7% deceased, and 10.8% had unknown HIV/vital status. Being newly diagnosed with HIV at ANC enrollment was the only factor associated with becoming LTFU (aRR 1.21, 95% CI: 1.11 to 1.31). Outcomes among those LTFU were worse than those retained in care, underscoring the importance of retention in PVT services. Some, but not all, LW re-engaged in care by 3 years, suggesting the need for PVT services must better address the barriers and transitions women experience during pregnancy and postpartum.

Customers on the Move: Predicting Customer Satisfaction among Mobile Banking Users in Malaysia

In recent decades, the financial industry has seen rapid modernization of information technology and increased competition. Nevertheless, numerous past studies have shown that technological adoption in mobile banking is relatively low in certain Southeast Asian countries. Customers' opposition to mobile banking services is mostly attributed to a lack of knowledge, security worries, and technological difficulties. Therefore, financial service providers need to comprehend and meet customer expectations to enhance the mobile banking experience. This, the present research seeks to examine the determinants of customer satisfaction with mobile banking among Malaysian consumers. The findings demonstrate that perceived ease of use, efficiency, and responsiveness were significant in influencing customer satisfaction. However, interoperability, privacy and security, and reliability were not significant in affecting mobile banking satisfaction. The findings have implications for both theoretical and practical perspectives, highlighting the need for efficient mobile banking services, enhancing financial inclusion, and empowering individuals.

Emphasizing the need for preconceptional, prenatal genetic counseling and comprehensive genetic testing in consanguinity: challenges and experience.

Preconception and prenatal genetic counseling is a well-established means of risk assessment in many parts of the world, and in recent years, an emerging concept in India. Likelihood of an offspring having autosomal recessive disorder increases based on the degree of consanguinity. Hence, genetic testing of the couple for the identification of carrier status for disease-causing variants is crucial. The purpose of this study is to understand the frequency of genetic abnormalities in consanguineous marriages by using a comprehensive genetic testing algorithm where in karyotyping, FISH, exome sequencing and microarray are used sequentially to determine the genetic etiology based on the clinical presentation and to evaluate the need and benefits of preconceptional and prenatal genetic counseling. This retrospective study includes 66 couples having consanguinity referred for genetic counseling and testing. Of the 66 couples, 58 underwent comprehensive genetic testing which included Karyotyping, Fluorescence in Situ Hybridization (FISH), Microarray and Exome sequencing based on their clinical presentation. The analyses revealed a genetic abnormality in approximately 31% and chromosomal polymorphic variations & variants of uncertain significance in 17% of the couples. Counseling in these couples helped in identifying the carrier status and enabled them to take an informed decision in subsequent pregnancies. These findings reiterate the acute need for preconception and prenatal genetic counseling services in India.

The modified 5-factor frailty index predicts postoperative outcomes in patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy

ObjectiveThe objective of this research is to compare the ability of mFI5 to the mFI11 to predict frailty, postoperative complications, discharge location for patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) at time of cytoreductive surgery. MethodsThis is a single-institution retrospective study in patients with advanced (Stage III, IV) or recurrent ovarian cancer treated with surgical cytoreduction with HIPEC. Logistic regression was used to evaluate frailty as well as factors associated with moderate to severe Accordion postoperative complications and discharge to home. Correlation was calculated between mFI5 and mFI11. ResultsOf 141 patients who received HIPEC between 2010 and 2020, 23 patients were classified as frail (mFI5 score ≥2), while 118 were not frail. Frail patients were significantly older with mean age 65.9 compared to non-frail patients who had mean age of 59.1 (p = 0.005), as well as a higher Charlston Comorbidity Index (p < 0.001), and more renal disease (p = 0.025), hypothyroidism (p = 0.005), and hyperlipidemia (p = 0.004). mFI5 and mFI11 scores for frailty were highly correlated (spearman rho 0.98, p < 0.001). Frail patients were more likely to be discharged to a skilled nursing facility (22.7 %) vs. 6.8 % of non-frail patients, or require home services (18.2 % vs 8.5 %, p = 0.025). On multivariable logistic regression, frail patients were more likely to experience moderate or higher Accordion postoperative complications (OR 3.08, p = 0.024). ConclusionsThe mFI5, a simpler tool than the mFI11, is also highly associated with postoperative complications and need for postoperative services in patients with ovarian cancer undergoing HIPEC at time of cytoreductive surgery.

A comparative analysis of supportive care service needs in patients with pancreas versus other gastrointestinal cancers.

272 Background: Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer death and presents with advanced incurable disease approximately 75% of the time, contributing to the lowest survival rate and worst multidimensional quality of life (QOL) compared to other adult solid tumors. Standardized screening for early integration of interdisciplinary care (IDC) services, advance care planning, and utilization of electronic patient-reported outcomes (ePROs) for improved QOL and symptom management are recommended, yet the literature is lacking in rigorously-conducted PDAC needs assessments, an important prerequisite to care model design. Methods: Between September 12, 2023 and May 7, 2024, 525 patients with gastrointestinal (GI) malignancies were sent a Supportive Care Questionnaire (SCQ), an ePRO survey assessing multi-dimensional IDC needs prior to first visit at an NCI-designated comprehensive cancer center in the Pacific Northwest. The SCQ includes validated surveys and a total of 12 domains chosen by the IDC service responsible for management of the given need(s), who also set trigger thresholds for referral to the IDC service. Rates of positive screens for each service were compared by cancer type (PDAC, Colorectal [CRC], gastroesophageal [GE]). Results: 340 (65%) SCQs were completed (57% via MyChart, 43% in person) similarly across disease groups; with an average of 10 mins to complete. Respondents were 49% female/59% male (Race: White (76.5%), Asian (10%), Black/African-American (4.5%), Other/Unknown (9%)/Ethnicity Non-Hispanic (90%, Hispanic 7.6%), Other/Declined/Unknown 2.4%), with primary language spoken being English (92%), Spanish (3.5%), simplified Chinese (1.5%) and Other (2.5%). Table 1 shows – by GI cancer type –the total number of responses and the proportion of patients who screened positive for one or more IDC services. Conclusions: Patients with PDAC had the greatest need for IDC services with most frequent positive screens indicating need for nutrition, social work, palliative care and patient navigation services when surveyed in our institution-wide program of SC screening for all new GI cancer patients. Results will inform further development of IDC services in PDAC and other GI cancers, including via staff prediction modeling. The SCQ is also being considered for SC screening and management across the Canopy Cancer Collective, a nationwide learning health network of pancreas cancer programs. PDAC CRC GE Surveyed 187 237 101 Completed 122 (65%) 153 (65%) 65 (64%) Positive Screen 68 (56%) 70 (46%) 26 (40%)